The esthesioneuroblastoma (ENB) is characterized as a rare malignant sinonasal tumor of neuroectodermal origin. Its starting point is the olfactory epithelium located in the upper part of the nasal cavities. Different nomenclatures have been proposed, but the most common are „esthesioneuroblastoma“ and „olfactory neuroblastoma“. ENBs have a bimodal distribution and mainly occur in teenagers, young adults and people aged 50-60. It is a very rare tumor in pediatrics since only around 100 cases have been reported so far. Within ENBs, we can distinguish tumors with different biological behavior ranging from localized forms with slow evolution to aggressive and metastatic forms at onset. In addition, precisely diagnosing undifferentiated tumors and distinguishing them from other etiologies of sinonasal tumors are sometime difficult. Added to its very low incidence, these characteristics make the study of ENB complicated. The standard treatment currently includes broad surgery followed by radiation therapy in localized resectable tumors. Neoadjuvant chemotherapy is indicated in large unresectable tumors and in metastatic forms. However, in certain indications, such as high-grade operable tumors, the role of perioperative chemotherapy remains to be defined. The objective of this analysis is to detail current knowledge regarding ENBs‘ epidemiological, biological, clinical and radiological characteristics as well as how to manage ENB in young patients.

Children with laryngomalacia may present with obstructive sleep apnea (OSA). The role of polysomnography (PSG) in treatment decision making for laryngomalacia is not well defined. We aimed to investigate the prevalence of OSA in children with laryngomalacia and the role of PSG in treatment decision.

Retrospective medical record review of children with laryngomalacia, confirmed by direct laryngoscopy, during a period of 3 years. Demographic data, presenting symptoms, severity classification, comorbidities and pre- and postoperative PSG data were retrieved and analyzed. Data are expressed as a median (25th – 75th percentile).

Forty-six patients were with diagnosed laryngomalacia between March 2016 and April 2019. A complete data set was available for 44 patients, 24 males and 20 females. The median age at the time of PSG was 12 weeks (6.3-29.8). Thirty-four children (77.4%) were diagnosed with concomitant OSA. A diagnosis of OSA changed the severity classification and treatment decision in 24 cases (54.5% active intervention with CPAP therapy or supraglottoplasty. Supraglottoplasty is a safe and effective surgical procedure for laryngomalacia. When performed in the setting of laryngomalacia with concomitant OSA, it also significantly improves OSA symptomatology.

The study aimed at testing the effect of supra segmental training on vocal emotional prosody perception of children with hearing impairment. The objectives of the study were to compare the perception of vocal emotional prosody (happy, sad, and neutral) in children with hearing impairment with and without a short-term prosody training and to draw correlations between the vocal emotional prosody perception scores and the subject factors – chronological age, age of hearing aid fitting, duration of the intensive intervention (speech, language and auditory training without breaks more than 30 days) and language age in children with hearing impairment.

Thirty children with hearing impairment in the age range of 4.1-9.2 years with a language age of 3-7 years participated in the study. The authors formulated 24 concrete Malayalam sentences and their picture representations and these were recorded under three emotional variations (happy, sad, and neutral). Using random sampling, the thirty participants were dividetrategies.

The results of the study points out that with adequate prosody training, the children with hearing impairment using benefiting hearing aids could improve their vocal emotional prosody perception. Owing to the role of prosody perception in speech & language, social and cognitive development, the supra segmental training should be made an integral part of the assessment and management intervention strategies.

Children with tracheostomy are a heterogeneous population requiring care from multiple specialties. Multidisciplinary approaches to treating such patients helps to improve the quality of care they receive. Takeda 779 Our institution established a Multidisciplinary Tracheostomy Clinics (MDTC) to address outpatient care coordination for tracheostomy patients by providing care from multiple disciplines at a single visit. We report patient/caregivers‘ experiences of our MDTC.

Patients with tracheostomy or their caregivers were prospectively recruited between Dec 2017-Oct 2019 to complete surveys assessing their experience at the MDTC. Demographic and satisfaction questionnaires were sent electronically by a REDCap survey distribution tool. Demographic data were collected, such as patient’s residence and education level. Medical care variables assessed included history of MDTC attendance, commute time, medical specialties seen, tracheostomy „Go-Bag“ use, home-care nursing, and MDTC satisfaction ratings.

Twenty-nine pattion and facilitation of care through a Multidisciplinary Tracheostomy Clinic.

Incisionless otoplasty is a more recently described technique to correct prominent ears. It is thought to provide a more natural cosmetic look, easier to perform, and achieve quicker recovery when compared to conventional otoplasty. The safety and efficacy of the procedure is not well characterised as there is limited data on outcomes and complications.

This was a retrospective study to evaluate outcomes and complications of incisionless otoplasty. We included all children who underwent incisionless otoplasty by a single surgeon over a 9-year period at a tertiary paediatric ear, nose and throat (ENT) unit.

A total of 32 children were included in this study (62 ears operated on). Using facial dimension measurements to analyse preoperative and postoperative photographs, the proportion of prominent ears reduced from 43/56 (76.8%) to 8/45 (17.8%). The children reported good cosmetic outcomes in 38/40 (95.0%) ears. Assessment of preoperative and postoperative photographs considered 34/39 (87.2%) to have good cosmetic result. The following rates of complications were observed infection, 6/62 (9.7%); blistering, 14/62 (22.6%); bleeding, 1/62 (1.6%); suture breakage/extrusion, 8/62 (21.9%); skin necrosis, 1/62 (1.6%). Further otoplasty procedures were done on five ears (8.3%).

Incisionless otoplasty was associated with high success and satisfaction rates. A previously undescribed complication of early postoperative erythema, swelling and blistering may be unique to this technique. This procedure should be further evaluated to identify risk factors and preventative measures to reduce complications.

Incisionless otoplasty was associated with high success and satisfaction rates. A previously undescribed complication of early postoperative erythema, swelling and blistering may be unique to this technique. This procedure should be further evaluated to identify risk factors and preventative measures to reduce complications.

The Oticon™ wide implant system was launched in 2009 and used at Birmingham Children’s Hospital from 2014. To evaluate clinical outcomes of the Oticon™ wide implant (Oticon Medical), with a focus on skin complication rates and fixture loss over a 5-year period in a tertiary paediatric hospital in the UK.

Retrospective 5-year longitudinal case record review of 47 children who were implanted with the Oticon™ wide implant system at Birmingham Children’s Hospital (BCH) between January 2014 and January 2016.

47 children (27M20F) were implanted with 70 Oticon wide implants 23 bilateral, 27 unilateral. Mean age at the time of implantation was 9y 6m. The follow up was for a mean of 5.4 years. Significant soft tissue complications requiring treatment was found in 11% (n=8) of loaded fixtures, abutment tightening on two patients, abutment exchange 6% (n=4) and a 10% (n=7) fixture failure.

The Oticon™ wide implant system produces favourable results with regards to peri-abutment skin complications, fixture stability and revision surgery rates when compared to similar cohorts of children studied at Birmingham Children’s Hospital.

The Oticon™ wide implant system produces favourable results with regards to peri-abutment skin complications, fixture stability and revision surgery rates when compared to similar cohorts of children studied at Birmingham Children’s Hospital.

To determine the voice onset time (VOT) values of Turkish speaking schoolchildren and to evaluate the effect of gender, age and vowel height on VOT values in this age group.

One hundred and twenty native Turkish children between the ages of 7-11 years were included in the study. All children were divided into 4 age groups Group I 7.0 to 7 years, 11 months; Group II 8.0 to 8 years, 11 months; Group III 9.0 to 9 years, 11 months; and Group IV 10.0 to 10 years, 11 months. The six Turkish plosive sounds (/p/,/b/,/t/,/d/,/k/,/g/) and the eight Turkish vowel sounds (/a/,/e/,/ɯ/,/i/,/o/,/oe/,/u/,/y/) were compiled into 48 different syllables, such as/pa/,/be/,/ti/, and/ko/. The syllables were repeated three times and were recorded by Behringer C-1 studio condenser microphone. Records were analysed by Praat software. The VOT values was established by measuring the time between temporary plosion of the pause and the onset of vocal fold vibration.

The mean voice onset time values of the voiced and voiceless plosiof voiceless plosive sounds and has a variable effect on voiced plosive sounds.

The VOT values of voiceless plosive sounds in Turkishspeaking schoolchildren were positive and the VOT values of their voiced plosive sounds were found negative. It was established that the height of the following vowel increases the VOT values of voiceless plosive sounds and has a variable effect on voiced plosive sounds.

Direct laryngoscopy in children is usually performed with spontaneous ventilation and monitored by pulse oximetry. It is currently unknown if spontaneous ventilation has an effect on cerebral oxygenation. We hypothesized that cerebral oxygenation may be impeded during direct laryngoscopy with spontaneous ventilation in children.

Our objective was to determine if children who undergo direct laryngoscopy under general anesthesia with spontaneous breathing experience significant reductions in cerebral oxygen saturation levels, and whether or not these reductions are accompanied by decreases in peripheral oxygen saturation levels.

This pilot study included 16 consecutive children who underwent direct laryngoscopy under general anesthesia and spontaneous ventilation. The INVOS™ system, which is currently used to monitor cerebral oxygen saturation levels during neurosurgery and cardiothoracic surgery, consists of a processing unit and 2 sensors that are applied to the patient’s forehead. We used it to record der general anesthesia with spontaneous ventilation may display reductions in brain oxygenation levels that are not detected by standard pulse oximetry, which reflects only peripheral oxygenation levels. Further study is required to explore the possible effect of this phenomenon in children who undergo direct laryngoscopy.